What is a cash flow waterfall?

A cash flow waterfall is a bar chart that walks from operating cash flow through capital expenditure to free cash flow, then shows how the remaining cash is allocated — acquisitions, buybacks, dividends, debt, and other financing — ending at the net change in cash. Each step is colour-coded: green bars add to the running total, red bars subtract.

How does HCA Healthcare (HCA) spend its free cash flow?

For TTM through Q1 2026, HCA Healthcare generated $13B of operating cash flow and $7.93B of free cash flow — a free cash flow margin of 61% of operating cash flow. The waterfall breaks down how the remaining cash was allocated across investing and financing activities.

How much did HCA Healthcare (HCA) return via buybacks and dividends?

The waterfall shows buybacks (share repurchases) and dividends paid as separate steps in the financing section. Together these represent HCA Healthcare's shareholder returns for TTM through Q1 2026. You can compare these against free cash flow to assess the capital-return payout ratio.

HCA Healthcare (HCA) Cash Flow Waterfall

Operating CF

$13B

Capex

-$5.07B

Free Cash Flow

$7.93B

FCF Margin

+61.0%

Cash flow waterfall for HCA Healthcare (HCA) — TTM through Q1 2026

Free cash flow: $7.93B

Cash flow breakdown for HCA Healthcare (HCA) — TTM through Q1 2026

Line item	Amount	Running total
Operating Cash Flow	$13B	$13B
Capital Expenditure	-$5.07B	$7.93B
Free Cash Flow	$7.93B	$7.93B
Acquisitions	-$324M	$7.6B
Other Investing	$158M	$7.76B
Share Buybacks	-$9.13B	-$1.37B
Dividends Paid	-$682M	-$2.05B
Net Debt Change	$3.08B	$1.03B
Other Financing & FX	-$1.15B	-$120M
Net Cash Decrease	-$120M	-$120M

Operating Cash Flow$13B
Capital Expenditure-$5.07B
Free Cash Flow$7.93B
Acquisitions-$324M
Other Investing$158M
Share Buybacks-$9.13B
Dividends Paid-$682M
Net Debt Change$3.08B
Other Financing & FX-$1.15B
Net Cash Decrease-$120M

Want to see what drove the FCF change?Free Cash Flow Bridge

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